Grant Application

Fill out the form below or download and email five (5) copies of the completed application by United States Mail or one (1) copy by e-mail, including all attachments, to:

Andrew Bow, Chair The Lindorf Family Foundation
PO Box 596, Granville, OH 43023
E-mail: thelindorffoundation@gmail.com.

I. COVER SHEET

Date

YYYY

Name

First Name

Last Name

Address of Organization

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Email

Names and titles of trustees, officers and executives

Telephone numbers of contact person and for the organization’s main office

A short statement summarizing the proposal that demonstrates its relationship to the organization’s mission

The total cost of the project and the amount requested from the Foundation

II. NARRATIVE

Brief summary of organization’s history, including mission and goals

Short description of current programs, activities, accomplishments, including the number of persons in Licking County and outside Licking County who receive benefits or services:

Statement of needs/problems to be addressed with grant funds; description of target population and benefit to the target population

Implementation schedule, length of time for project, long-term strategies for funding this project after funding from the Lindorf Family Foundation is expended

List of other organizations from which funding has been requested for this project, including amount requested and response

How an evaluation of the project will be conducted and a timeline for delivering the results to the Foundation

III. ATTACHMENTS

• Most recent annual financial statement • Most recent 990 tax return • Organization’s previous and current annual operating budget • Project budget • Copy of current IRS determination letter • Additional documentation Send all to: thelindorffoundation@gmail.com